American Health Care: Realities, Rights, and Reforms

Hardcover | April 1, 1990

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Is our present health care system biased against people with limited education and income? Does every American have a moral right to health care? If so, what kinds of care and how much? In a provocative look at American health care delivery, Charles J. Dougherty considers these and manyother questions. His book fills an important niche in contemporary medical ethics and public health literature by combining a description and analysis of the American health care system--as it actually operates today--with an assessment of recent philosophical writings on justice. In the firstsection, Dougherty describes inequalities in health care delivery to blacks, the poor, and the less educated. He then reviews the philosophical theories of utilitarianism, egalitarianism, contractarianism, and libertarianism; applies them to health care issues; and argues for a moral right tohealth care. He considers available policy alternatives, concluding that the empirical data and our understanding of justice and human rights should commit us to a national health care plan supported by national health insurance.

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Table of Contents

Part I: Realities1. Some American Health Care Realities: Access to Needed Care; Quality of Care; Rising CostsPart II: Rights2. A Right to Health Care: The Concept of a Right; For and Against a Right to Health Care3. Utilitarianism: Optimal Consequences; Prudent Insurance4. Egalitarianism: Equal Intrinsic Value; Substantive Equality5. Libertarianism: Liberty and Ownership; Compensatory Rights6. Contractarianism: The Social Contract; Liberty, Opportunity, and Wealth7. Plural Foundations: Proof and Persons; Four Health Care Rights; Rights, Clarity, and IdealsPart III: Reforms8. Market Reforms: Pure Competition; A Hobbled Market9. DRGs, HMOs, and Vouchers: Price Controls; Prepaid Group Practice; Cash and Voucher Plans10. National Health Care Plans: Medicare and Medicaid; National Health Insurance; A National Health Care Service

Editorial Reviews

"Excellent treatment of ethical issues in health care reform. Dougherty's argument for the existence of a right to health care for all Americans--but especially for disadvantaged ones--is much needed in today's health care reform deabate."--Professor Karen L. Baird, SUNY, Purchase.